Call Center Representative - Remote (USA)

Summary

Gainwell Technologies makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people can access the care they need—today and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, improve quality, and meet compliance goals. At Gainwell, you’ll build valuable skills, advance your career, and make a meaningful difference in people’s lives.

Your role in our mission

• Answer inbound calls and provide courteous, accurate, and efficient customer service.
• Follow established quality and compliance standards for every interaction.
• Verify caller identity and ensure all security and confidentiality procedures are followed.
• Access and review program details using internal systems (e.g., DE) to answer inquiries within program guidelines.
• Communicate clear and accurate information in every interaction.
• Provide knowledgeable responses to general client questions; escalate complex cases as needed.
• Document all interactions accurately in the system and follow up on pending inquiries.
• Meet or exceed productivity and service-level agreements (SLAs).
• Collaborate with team members, management, and clients to resolve issues effectively.
• Recommend improvements to processes or workflows to enhance efficiency.

What we're looking for

• High school diploma or GED required; additional education preferred.
• 2+ years of call center or customer service experience preferred.
• Experience in a healthcare or insurance environment is a plus.
• Strong customer service orientation with excellent verbal and written communication skills.
• Proficient in Microsoft Outlook, Word, and Excel; familiarity with help desk or CRM systems is a plus.

What you should expect in this role

• This is a remote position in the USA. 
• This position operates Monday through Friday, with shifts scheduled within our standard office hours of 6:50 AM to 6:30 PM CST.
• Specific shift assignments will fall within this time range based on business needs.
• Requires ability to communicate clearly via phone and computer; manual dexterity for office equipment use.
• Harver Assessment Requirement: As part of our interview process, all candidates must complete the Harver Assessment. This assessment helps us evaluate key competencies relevant to the role, including communication skills, multitasking abilities, and problem-solving capabilities.
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
  To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
• To Test your internet download and upload speed:
  • Go to Google.
  • Search for Internet Speed Test or click here.